Chest
Ketanserin, A Serotonin Antagonist: Administration in Patients with Acute Respiratory Failure
Section snippets
Patients and Methods
The study included eight patients who had no history or clinical evidence of chronic pulmonary disease or abnormal left ventricular function. Each patient developed acute respiratory failure, characterized by hypoxemia associated with bilateral pulmonary infiltrates on the chest roentgenogram within three days after an episode of circulatory shock. Hemodynamic stability had been obtained, and no vasoactive drug was administered at the time of the study. The clinical data are presented in Table 1
Results
The bolus injection of ketanserin was rapidly followed by a significant decrease in aortic pressure and moderate systemic hypotension persisted until 30 minutes after the end of the infusion (Fig 1). Significant decreases in pulmonary artery pressure and right atrial pressure were observed during the infusion. Pulmonary artery balloon-occluded pressure also decreased moderately.
Heart rate and cardiac index were not significantly affected (Fig 2). Systemic vascular resistance transiently
Discussion
Several phenomena can be involved in the development of acute respiratory failure, including platelet and leukocyte aggregation, formation of microthrombi, complement activation, or development of disseminated intravascular coagulation.13,14 Among other substances, serotonin can be locally released in the injured lung in larger amounts than normal.1,2 Serotonin clearance by the reticuloendothelial system may also be depressed during shock, trauma, or sepsis.16 While more than 90 percent of
ACKNOWLEDGMENT:
Ketanserin was supplied by Janssen Pharmaceutica (Beerse, Belgium).
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Presented at the Annual Meeting of the American Thoracic Society, Kansas City, May 8-11, 1983